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 NOVEMBER 30, 2008 New Treatment Eliminates Heel Pain Caused by Plantar Fasciitis If your heel hurts after jogging or playing tennis, and the first few steps out of bed in the morning are painful, you likely have plantar fasciitis. A new treatment that uses ultrasound-guided steroid injections may relieve this common, painful foot problem if conservative care does not. Plantar fasciitis is the most common cause of heel pain, accounting for up to 15% of all foot symptoms requiring professional care and affecting 1 million Americans each year. The plantar fascia is the elastic covering on the sole of the foot that holds up the arch. It runs the length of the foot, from behind the toe bones to the heel bone. When this shock-absorbing pad becomes inflamed, that's called plantar fasciitis, and it can cause a dull ache along the length of the arch. Conservative treatments, including rest, exercises to stretch the fascia, night splints and arch supports or orthotics, may take up to a year to be effective. When the condition does not respond, many people try shockwave therapy, in which sound waves are directed at the area of heel pain to stimulate healing. However, shockwave therapy is painful, requires multiple treatments and is not always effective. If nothing works, your doctor may recommend corticosteroid injections into the region of the plantar fasciia attachment to the heel. A study presented on November 30 at the annual meeting of the Radiological Society of North America used a new ultrasound-guided technique along with steroid injection on 44 patients with plantar fasciitis that was unresponsive to conservative treatments. After injection of a small amount of anesthesia, the anesthetic needle was used to repeatedly puncture the heel, a technique known as dry-needling. Dry-needling creates a small amount of local bleeding that helps to heal the fasciitis, said lead author Luca M. Sconfienza, MD, from the University of Genoa in Italy. Then, with ultrasound guidance to improve accuracy, steroid was injected around the fascia to eliminate the inflammation and pain. Symptoms disappeared for 42 of the 44 patients within three weeks. "This therapy is quicker, easier, less painful and less expensive than shockwave therapy," Dr. Sconfienza said. "In cases of mild plantar fasciitis, patients should first try noninvasive solutions before any other treatments. But when pain becomes annoying and affects the activities of daily living, dry-needling with steroid injection is a viable option." |
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